1467830927 NPI number — ELEANOR MAGAN GRAMLING OTR/L, CLT

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1467830927 NPI number — ELEANOR MAGAN GRAMLING OTR/L, CLT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GRAMLING
Provider First Name:
ELEANOR
Provider Middle Name:
MAGAN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
OTR/L, CLT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
GRAMLING
Provider Other First Name:
ELEANOR
Provider Other Middle Name:
MAGAN HIGGINS
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1467830927
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/20/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1717 6TH AVE S
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BIRMINGHAM
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
35233-1801
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
205-975-1279
Provider Business Mailing Address Fax Number:
205-934-2733

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
153 NARROWS PKWY STE 101
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BIRMINGHAM
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35242-8601
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
205-981-4534
Provider Business Practice Location Address Fax Number:
205-981-4535
Provider Enumeration Date:
05/15/2015

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225X00000X , with the licence number:  3545 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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